The Study On The Influencing Factors Of Resilience In Patients With Breast Cancer After Operation

Objective The aims of this study were to analyze the status and influencing factors of resilience in postoperative breast cancer patients,and to explore the path relationships between resilience and its protective factors.In order to provide reference basis for clinical nurses to take targeting interventions in postoperative breast cancer patients,to enhance the coping ability of patients by increasing their resilience levels,and to further improve the quality of life in postoperative breast cancer patients.Methods In this cross-sectional survey,A total of 287 postoperative breast cancer patients were recruited from the breast surgery ward at a top-three hospital in Kaifeng between October 2016 and July 2017.The contexts of this study included: a self-designed general information questionnaire,the Connor-Davidson Resilience Scale(CD-RISC),Herth Hope Index(HHI),and Social Support Rating Scale(SSRS).Epidata3.1 was used to establish the database,and data was analyzed by using SPSS22.0.Statistical methods included descriptive analyses(frequency,percentage,mean,standard deviation),Independent-Sample T tests,One-Way ANOVA,Pearson correlation analysis,Multiple regression analyses and Bootstrap mediation test.The data were presented as mean ± SD or frequency(percentage).Independent-Sample T tests and One-Way ANOVA were performed to explore the association of general information and resilience among patients.Pearson correlation analysis was conducted to test the levels of relationship between resilience,hope level and social support;Multiple linear regression analysis was used to investigate influencing factors of resilience in postoperative breast cancer patients;Bootstrap mediation test was used to analyze the mediating effects of hope level between resilience and social support.Results1.Current descriptionThe mean level of resilience in postoperative breast cancer patients was 60.87±12.55 scores the strength dimension was 21.25±4.25 scores,the tenacity dimension was 30.60±7.30 scores,and the optimism dimension was 9.02±2.46 scores.The mean level of hope in postoperative breast cancer patients was 36.39±4.14 scores,the temporality and future dimension was 11.71±1.72 scores,the positive readiness and expectancy dimension was 12.40±1.50 scores,and the interconnectedness dimension was 12.28±1.51 scores.The score of hope was at medium or higher level.The mean level of social support in postoperative breast cancer patients was 37.29±6.01 scores,the subjective support dimension was 22.66±4.39 scores,the objective support dimension was 8.02±1.84 scores,and the utilization level of support dimension was 6.61±2.09 points.The score was at medium level,which was lower than that at the domestic norm.2.Univariate analysisEducation levels,occupation,average monthly income of family,medical insurance,and surgical methods,were significantly associated with resilience in postoperative breast cancer patients(P<0.05).In addition,patients with college education or above had higher scores of resilience.Those who had a family income of less than 1,000 yuan per month,were farmers,paid for the new cooperative medical scheme and had a radical surgery,had lower resilience scores.Resilience was positively correlated with hope level and social support,respectively(hope level: P<0.01,r=0.674;social support: P<0.01,r=0.396),.There was a significant positive correlation between hope level and social support(P<0.01),The correlation coefficient was 0.344.3.Multiple linear regression analysisThe results of multiple linear regression analysis showed that the temporality and future,the positive readiness and expectancy,education level,interconnectedness and subjective support can explain 51.4% of resilience variability.4.Mediation AnalysisThe results of the Bootstrap mediation test revealed that hope level had a mediator effect between resilience and social support in postoperative breast cancer patients.The mediating effect was 52.96%(ratio of mediating effect to total effect).Conclusions1.The resilience in postoperative breast cancer patients need to be further improved.2.The influencing factors of resilience in postoperative breast cancer patients include the temporality and future,the positive readiness and expectancy,education level,interconnectedness and subjective support.3.The hope level had a mediator effect between resilience and social support in postoperative breast cancer patients.